Oral Pathology - Chapter 4

Front 1

Which form of immunity response is responsible for intracellular bacteria such at TB; viruses, and fungi?

Back 1

Cell-mediated immunity

Front 2

A tumorlike mass of inflammatory tissue consisting of a central collection of macrophages, often including multinucleated giant cells, surrounded by lymphocytes.

Back 2

Granuloma
1. A disease characterized by granulomas.

Hint 2

Granulomatous disease

Front 3

A vague, indefinite feeling of discomfort, debilitation, or lack of health.

Back 3

Malaise

Front 4

A disease caused by a microorganism that does not ordinarily cause disease but becomes pathogenic under certain circumstances.

Back 4

Opportunistic infection

Front 5

An abnormal sensation such as prickling or tingling.

Back 5

Paresthesia

Front 6

A microorganism that causes disease

Back 6

Pathogenic microorganism

Front 7

Itching

Back 7

Pruritus

Front 8

An infectious disease not detectable by the usual clinical sings.

Back 8

Subclinical infection

Front 9

An infection involving the distal phalanx of a finger.

Back 9

Whitlow

Front 10

A bacterial skin infection caused primarily by Staphylococcus aureus and occasionally Streptococcus pyogenes; occurs on the skin of face or extremities in young children.

Back 10

Impetigo

1. What is the mode of trasmission?
2. Cinical signs/symptoms?
3. What does it resemble?
4. Dx?
5. Tx?

Hint 10

1. Direct contact
2. Vessicles that rupture, Longer-lasting bullae, Itching, Regional lymphadenopathy
3. Recurrent herpes simplex infection
4. Clinical appearance, cultures of the lesions
5. Topical or systemic antibiotics

Front 11

An inflammatory condition of the tonsils and pharyngeal mucosa caused by streptococci, adenoviruses, influenza virus, and Eptstein-Barr virus.

Back 11

Tonsillitis and pharyngitis

0. Clinical appearance.
1. Mode of transmission.
2. Dx
3. Tx
4. Conditions associated with these; caused by group A-B hemolytic streptococci; occurs in children, causes red skin rash.
5. What is the clinical appearance of this related condition.

Hint 11

0. Sore throat, Fever, Tonsillar hyperplasia, Erythema of the tonsils and oropharyngeal mucosa.
1. Contact with nasal and oral secretions
2. Rapid antigen detection test
3. Antibiotics
4. Scarlet fever
5. Petecchiae on the soft palate and strawberry tongue and red skin rash

Front 12

Inflammatory reaction involving the heart, joints, and central nervous system; may cause permanent damage to the heart valves.

Back 12

Rheumatic fever

Front 13

Infectious chronic granulomatous disease caused by the organism Mycobacterium tuberculosis that affects the lungs.

Back 13

Tuberculosis

1. Mode of transmission.
2. Clinical signs/symptoms.
3. If it involves the kidneys and liver it's called?
4. If it involves the submandibular and cervical lymph nodes it's called?
5. Most common sites for oral lesions and appearance.
6. Dx
7. What is the name of antigen injected into the skin?
8. Tx
9. Can you proceed with dental treatment?

Hint 13

1. Inhaled droplets
2. Fever, chills, fatigue, malaise, weight loss, persistent cough
3. Miliary Tuberculosis
4. Scrofula or Tuberculosis lymphadenitis
5. Tongue and palate; painful, nonhealing, slowly enlarging superficial or deep ulcers.
6. Biopsy, Microscope, Tissue culture, skin test, chest radiograph
7. PPD (purified protein derivative)
8. Isoniazid and rifampin among other drugs; treatment for months up to 2 years.
9. No, routine dental treatment is deferred.

Front 14

Infection caused by a filamentous bacteria called ___________; forms abscesses that tend to drain by the formation of sinus tracts; organisms appear in the pus as tiny, bright yellow grains called sulfur granules.

Back 14

Actinomycosis
Actinomyces israelii

1. Dx
2. Causes
3. Tx.

Hint 14

1. Microscope
2. Infection seems to follow tooth extraction or an abrasion of the mucosa.
3. High doses of antibiotics

Front 15

How do you diagnose Actinomycosis?

Back 15

Microscopic examination

Front 16

What is the cause for Actinomycosis?

Back 16

Infection seems to follow tooth extraction or an abrasion of the mucosa.

Front 17

Disease caused by the spirochete Treponema pallidum.

Back 17

Syphilis

1. Mode of transmission.
2. Three stages of syphilis.
3. What is the lesion in the primary stage?
4. What is the lesion in the secondary stage; when does this stage occur.
5. What is the lesion in the tertiary stage; when does it occur?
6. What type of syphilis causes irreversible damage to the child such as facial and dental abnormalities.
7. Dx?
8. Tx?

Hint 17

1. Direct contact, blood transfusions, transplacental, sexual contact.
2. primary, secondary, tertiarty
3. Chancre: which is the site where the spirochete enters the body.
4. Mucous patches: multiple, painless, grayish-white plaques covering the ulcerated mucosa; most infectious 6 weeks after primary stage.
5. Gumma: localized, noninfectious; common site tongue and palate; firm mass that becomes ulcer; can lead to perferation of palatal bone; years after initial infection.
6. Congenital syphilis
7. Darkfield examiination to identify spirochete; blood tests (VDRL and fluorescent treponemal antibody absorption test).
8. Penicillin

Front 18

Painful erythematous gingivitis with necrosis of the interdental papillae caused by fusiform bacillus and a spirochete (Borrelia vincentii).

Back 18

Necrotizing Ulcerative Gingivitis (NUG)

1. Clinical appearance

Hint 18

1. Foul odor, metallic taste, cratered interdental papilla, fever, cervical lymphadenopathy

Front 19

Inflammation of the mucosa around the crown of partially erupted or impacted teeth.

Back 19

Pericoronitis

1. Where is it most likely present?
2. Dx
3. Tx
4. Causes

Hint 19

1. Soft tissue around the mandibular third molar
2. Clinical presentation; swollen, erythematous, and painful.
3. Debridement and irrigation, systemic antibiotics, extraction of molar.
4. From minor illnesses to immunodeficiency; trauma from opposing molar and impaction of food.

Front 20

Inflammation of the bone and bone marrow that results of the extention of a periapical abscess caused by bacteremmia.

Back 20

Acute Osteomyelitis

1. Dx
2. Tx

Hint 20

1. Cultures, antibiotic sensitivity tests, microscope
2. Drainage of the area, antibiotics.

Front 21

Long term standing inflammation of the bone.

Back 21

Chronic osteomyelitis

1. What radiopacity develops, what is the condition called?
2. Dx.
3. Tx.

Hint 21

1. Chronic sclerosing osteomyelitis
2. Biopsy, histology exam, bacterial culture
3. debridement, systemic antibiotics, hyperbaric oxygen

Front 22

Most common oral fungal infection that occurs particularly in individuals who wear dentures.

Back 22

Candidiasis

1. aka
2. Fungus that causes it.
3. Overgrowth of candida albicans is associated with which conditions?
4. What are the 5 different types of candidiasis?
5. Severe form which occurs in immunocompromised patients.
6. Tx.

Hint 22

1. Moniliasis and Thrush
2. Candida albicans
3. Antibiotic therapy, cancer therapy, corticosteroid therapy, dentures, diabetes mellitus, HIV, Hypoparathyroidism, Infancy, multiple myeloma, primary T lymphocyte deficiency, xerostomia
4. Pseudomembranous
Erythematous
Denture stomatitis (chronic atrophic candidiasis)
Chronic hyperplastic (candida leukoplakia)
Angular cheilitis
5. Chronic mucocutaneous candidiasis
6. Topical and systemic meds.

Front 23

A white curdlike material that is present on the mucosal surface; where underlying mucosa is erythematous and there is occasional buring, metallic taste.

Back 23

Pseudomembranous Candidiasis

Front 24

Type of Candidiasis that is erythematous, often painful, can be localized or generalized.

Back 24

Erythematous Candidiasis

Front 25

Most common type of candidiasis affecting the oral mucosa; lesions are petechiae-like or more generalized and granular occuring on the palate and maxillary alveolar ridge; asymptomatic.

Back 25

Denture stomatis aka Chronic atrophic candidiasis

Front 26

Oral candidiasis that appears as a white lesion that does not wipe off the mucosa also known as __________.

Back 26

Chronic hyperplastic candidiasis
Candidal leukoplakia
Hypertrophic candidiasis

Front 27

How do you diagnose Chronic hyperplastic candidiasis?

Back 27

Response to antifungal medication; it disappears with antifungal medication.
Biopsy

Front 28

Candida organisms are often the cause of this condition which appears as erythema or fissuring at the labial commisures; may also be caused by nutritional deficiency.

Back 28

Angular cheilitis

Front 29

Condition associated with candidiasis that appears as an erythematous, often rhombus-shaped, flat-to-raised area on the midline of the posterior dorsal tongue.

Back 29

Median Rhomboid Glossitis

Front 30

Histoplasmosis, coccidioidomycosis, blastomycosis, and cryptococcosis are all examples of?

Back 30

Deep fungal infections

Front 31

Deep fungal infection that is widespread in midwestern US.

Back 31

Histoplasmosis

Front 32

Deep fungal infection that is widespread in western US, particularly San Joaquin Valley of California.

Back 32

Coccidioidomycosis

Front 33

Deep fungal infection that is more common in Ohio-Mississippi river basin area.

Back 33

Blatomycosis

Front 34

Deep fungal infection that is spread through inhalation of microorganisms contained in dust from bird droppings, particularly pigeons.

Back 34

Cryptococcosis

Front 35

How do you diagnose deep fungal infections?

Back 35

Biopsy
Microscopic examination
Special staining
Clinical appearance: chronic nonhealing ulcers that resemble squamous cell carcinoma.

Front 36

Deep fungal infection oral ulcers resemble?

Back 36

Squamous cell carcinoma

Front 37

How do you treat Deep Fungal Infections?

Back 37

Systemic antifungal medications such as Amphotericin B or ketoconazole or itraconazole

Front 38

Rare fungal disease where the organism is a common inhabitant of soil and is usually nonpathogenic.

Back 38

Mucormycosis

1. Usually occurs in patients who are?
2. Where does it manifest; appearance?
3. Dx

Hint 38

1. Diabetic and severly debilitated.
2. Nasal cavity, maxillary sinus, and hard palate; can present as a proliferating or destructive mass in the maxilla.
3. Biopsy

Front 39

Common wart; papillary oral lesion caused by human papilloma virus; common skin lesion; transmitted through direct contact; occurs mainly on the lips; can be transmitted through finger sucking or fingernail biting.

Back 39

Verruca Vulgaris

1. Clinical appearance.
2. Dx
3. Tx

Hint 39

1. White, papillary, exophytic lesion that closely resembles papilloma tumor.
2. Biopsy, Histologic exam, immunologic staining
3. Surgical excision, refrain from finger sucking.

Front 40

Benign papillary lesion caused by papilloma virus that can be transmitted through sexual contact and occurs most commonly in the anogenital region; transmitted through oral-genital contact or self-inoculation.

Back 40

Condyloma acuminatum

1. Appearance
2. Dx
3. Tx

Hint 40

1. Papillary, bulbous masses that can occur anywhere in the oral mucosa and multiple lesions may be present; more diffuse and not as well keratinized, pink.
2. Immunologic staining.
3. Conservative surgical excision, avoid oral-genital contact.

Front 41

Disease caused by the human papilloma virus that occurs mainly in children; presence of multiple whitish-to-pale pink nodules distributed throughout the oral mucosa; asymptomatic.

Back 41

Focal epithelial hyperplasia aka Heck disease

1. Dx
2. Tx

Hint 41

1. Histologic examination
2. No treatment necessary; asymptomatic; resolves in a few weeks.

Front 42

Oral infections of the herpes simplex virus are caused by which type?

Back 42

Type 1

Front 43

Genital infections of the herpes simplex virus are caused by which type?

Back 43

Type 2

Front 44

Name 4 other types of Herpes viruses.

Back 44

Varicella-zoster virus
Eptstein-Barr virus
Cytomegalovirus
Kaposi sarcoma-associated herpes virus

Front 45

Oral disease associated with the herpes simplex virus is called?

Back 45

Primary herpetic gingivostomatitis
1. Appearance
2. Signs/symptoms
3. Occurs in children of what age?
4. Tx

Hint 45

1. Painful, erythematous, swollen gingiva with multiple tiny vesicles on vermillion border, oral mucosa; vesicles progress to ulcers.
2. Fever, malaise, cervical lymphadenopathy
3. 6 M to 6 Y
4. The disease is self limited and lesions clear in 1 to 2 weeks.

Front 46

The most common recurrent herpes simplex infection that occurs on the vermillion borders of the lips is called?

Back 46

Herpes labialis aka fever blister or cold sore

Front 47

Recurrent herpes simplex infection can occur intraorally and found mostly where? What is the clinical appearance?

Back 47

Keratinized mucosa, fixed bone, hard palate and gingiva. Painful clusters of tiny vesicles or ulcers that can coalesce to form a single ulcer with irregular border.

Front 48

How is recurrent herpes simplex infection transmitted?

Back 48

Direct contact

Front 49

Herpes simplex virus can cause a painful infection of the fingers called?

Back 49

Herpetic whitlow

Front 50

How is the Herpes Simplex Infection diagnosed?

Back 50

Viral culture
Microscopic examination
Biopsy
Smear

Front 51

How is Herpes Simplex Infection treated?

Back 51

Antiviral drugs such as Acyclovir

Front 52

This virus causes the chicken pox and shingles.

Back 52

Varicella-Zoster Virus

Front 53

Highly contagious disease that causes vesicular and pustular eruptions of the skin and mucous membranes, along with systematic symptoms such as headache, fever, and malaise; usually occurs in children and is caused by the varicella-zoster virus.

Back 53

Chicken pox

Front 54

Adult disease caused by varicella-zoster virus that is characterized by a unilateral, painful eruption of vesicles along the distribution of a sensory nerve.

Back 54

Herpes Zoster or Shingles

1. Affects 3 branches of the trigeminal nerve.
2. Clinical appearance.
3. Dx
4. Tx
5. Occurs in association with which two other diseases?

Hint 54

1. Ophthalmic branch, maxillary branch, and mandibular branch
2. painful vesicles that progress to ulcers.
3. Clinical features; biopsy, smear, viral cultures
4. Antiviral drugs; corticosteroids
6. Hodgkins' disease and leukemia

Front 55

This virus causes several diseases including Mononucleosis, Nasopharyngeal carcinoma, Brukitt lymphoma, and Hairy leukoplakia.

Back 55

Epstein-Barr virus

Front 56

Infectious disease caused by the Epstein-Barr virus that is characterized by sore throat, fever, generalized lymphadenopathy, enlarged spleen, malaise, and fatigue.

Back 56

Infectious Mononucleosis

1. Clinical appearance of oral lesions.
2. Mode of transmission

Hint 56

1. Palatal petechiae
2. Contact with saliva during kissing.

Front 57

This irregular, corrugated white lesion occurs mostly on the lateral border of the tongue and is caused by the Epstein-Barr virus; occurs mostly in patients with HIV and immunocompromised patients.

Back 57

Hairy Leukoplakia

Front 58

Virus that causes several different infectious diseases such as Herpangina, Hand-Foot-and Mouth Disease, and Acute Lymphonodular Pharyngitis.

Back 58

Coxsackievirus

1. Dx
2. Tx

Hint 58

1. viral culture and blood tests
2. Treatment not required.

Front 59

Disease caused by the coxsackievirus which includes vesicles on the soft palate; along with fever, malaise, sore throat, and difficulty swallowing; erythematous pharyngitis is also present; mild to moderate and resolves in less than 1 week without treatment.

Back 59

Herpangina

Front 60

Disease caused by the coxsackievirus usually affects children younger than 5 years of age; painful vesicles and ulcers anywhere in the mouth, multiple macules and papules occur on the skin, typically on feet, toes, hands, and fingers; lesions resolve on their own within 2 weeks.

Back 60

Hand-Foot-and Mouth Disease

Front 61

Infection caused by coxsackievirus that is characterized by fever, sore throat, and mild headache; hyperplastic lymphoid tissue of the solf palate or tonsillar pillars appears as yellowish or dark pink nodules; lasts several days to 2 weeks; does not require treatment.

Back 61

Acute Lymphonodular pharyngitis

Front 62

Highly contagious childhood disease that causes skin rash that results from a type of virus called a paramyxovirus.

Back 62

Measles

1. Clinical appearance.
2. Name of the spots that occur in measles early in the disease.

Hint 62

1. Small erythematous macules with white necrotic centers that may also occur in oral cavity.
2. Koplik spots.

Front 63

Viral infection of the salivary glands that is caused by paramyxovirus and occurs in children.

Back 63

Mumps

1. Clinical appearance.

Hint 63

1. Painful swelling of the salivary glands, most commonly bilateral swelling of the paratid gland.

Front 64

1. What is the mode of transmission for HIV?
2. What cell does it maily affect?
3. What are the two tests?
4. What are the clinical manifestations?
5. How is it medically managed?

Back 64

1. Sexual contact, Infected blood, Tranplacental
2. CD4 T-helper lymphocyte
3. ELISA and Western blot test
4. Initially it may be asymptomatic, sore throat, malaise, myalgia, arthralgia, lymphadenopathy, fever, skin rash, nausea, diarrhea, dementia.
5. Antiretroviral drugs, highly active antiretroviral therapy (Haart or Art)

Front 65

What is the diagnosis of AIDS, what is it's definition?

Back 65

Adults and adolescents with HIV infection with severe CD4 lymphocyte depletion (less than 200 CD4 per microliter of blood.

Front 66

What is the normal count of CD4 lymphocytes per microliter of blood?

Back 66

550 to 1000

Front 67

What are the oral manifestations of AIDS and HIV infections?

Back 67

Oral candidiasis
Herpes Simplex Infection
Herpes Zoster
Hairy Leukoplakia
Papilloma Virus Infections
Kaposi Sarcoma
Lymphoma
Gingival and Periodonal Disease
Aphthous Ulcers
Salivary Gland Disease
Mucosal Melanin Pigmentation

Front 68

One of the most common oral lesions seen in persons with HIV infection; also called thrush; generally signals the beginning of a progressivly severe immunodeficiency.

Back 68

Oral candidiasis

Front 69

Ulceration of the oral mucosa from this infection that has been present for more than one month in HIV patients meets the criteria for the diagnoses of AIDS.

Back 69

Herpes simplex infection

Front 70

Condition caused by Epstein-Barr virus where in most cases is an oral manifestation of HIV infection; irregular white lesion that has corrugated surface and appears on the lateral borders of the tongue; fulfil criteria for AIDS

Back 70

Hairy Leukoplakia

Front 71

Opportunistic neoplams that occur in patients with HIV infection; oral lesions appear as reddish-purple, flat or raised lesions, and are seen anywhere in the mouth, most common location palate and gingiva; fulfill criteria for AIDS

Back 71

Kaposi Sarcoma

Front 72

Malignant tumor associated with HIV infection; appear as nonulcerated, necrotic, or ulcerated masses surfaced by either ulcerated or normal-colored erythematous mucosa.

Back 72

Non-Hodgkin lymphoma

Front 73

What are the three types of gingival and periodontal diseases associated with HIV infection?

Back 73

Linear gingival erythema (LGE)
Necrotizing Ulcerative periodontitis (NUP)
Necrotizing stomatitis

Front 74

What are the three characteristic features of Linear gingival erythema?

Back 74

Spontaneous bleeding
Punctate or petechiae-like lesions on the attached gingiva and alveolar mucosa
Bandlike erythema of the gingiva that does not respond to therapy

Front 75

What are the characteristic feature of necrotizing ulcerative periodontitis?

Back 75

Pain
Spontaneous bleeding
Interproximal necrosis
Interproximal cratering

Front 76

What are the features of necrotizing stomatitis?

Back 76

Bone loss

Front 77

What is the treatment for HIV gingivitis and periodontitis?

Back 77

Scaling
Root planning
Soft tissue curettage
Intrasulcular lavage with povidone-iodine
Chlorhexidine mouth rinse
Short term systemic metronidazole administration
Good oral hygiene

Front 78

List the bacterial infections.

Back 78

Impetigo
Tonsillitis & Pharyngitis
Tuberculosis
Actinomycosis
Syphilis
Necrotizing Ulcerative Gingivitis
Pericoronitis
Acute & Chronic Osteomyelitis

Front 79

List the fungual infections.

Back 79

Candidiasis
Angular Cheilitis
Median Rhomboid Glossitis
Mucormycosis
Histoplasmosis
Coccidioidomycosis
Blastomycosis
Cryptococcosis

Front 80

List the viral infections.

Back 80

Verruca Vulgaris
Condyloma Acuminatum
Focal Epithelial Hyperplasia
Primary Herpetic Gingivostomatitis
Recurrent Herpes Simplex Infection
Chicken pox
Herpes zoster
Infectious mononucleosis
Hairy Leukoplakia
Herpangina
Hand-Foot-and-Mouth Disease
Acute Lymphonodular Pharyngitis
Measles
Mumps
AIDS

Front 81

Which diseases/conditions are associated with the Epstein Barr Virus?

Back 81

Nasopharyngeal carcinoma
Burkitt lymphoma
Infectious mononucleosis
Hairy Leukoplakia

Front 82

Which diseases/conditions are associated with Coxsackievirus?

Back 82

Herpangina
Hand-Foot-and Mouth Disease
Acute Lymphonodular Pharyngitis

Front 83

Which diseases/conditions are associated with the human papilloma virus?

Back 83

Verruca Vulgaris
Condyloma Acuminatum
Focal Epithelial Hyperplasia